Breast Cancer Patients May Get Longer Radiation Than Needed

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Most women with early stage breast cancer are receiving long courses of radiation after a lumpectomy, even though shorter courses using high dose radiation are just as safe and effective and easier for patients to handle, a new study finds.

“It should be a win-win-win and yet we’re not using it,” co-author Dr. Ezekiel Emanuel of the University of Pennsylvania’s Perelman School of Medicine told NBC News.

Most women with early stage breast cancer opt to have breast-conserving surgery, or lumpectomy. Studies show that this surgery combined with radiation gives women the same chance of survival as if they were to choose a mastectomy, in which the whole breast is removed.

Conventionally, radiation treatment is given over the course of 5-7 weeks, with daily visits to the doctor’s office. But several large studies have found that an accelerated radiation treatment given at higher doses over a course of 3-5 weeks is just as effective as the longer course at preventing breast cancer recurrence.

But the new study published Wednesday in JAMA finds that two-thirds of women are still getting the longer course of radiation. “I think radiation oncologists know they should be using it but it’s very very slow uptake whereas in other countries 70-80 percent of women are getting this [accelerated] treatment,” Emanuel said.

So why are women still getting the longer treatment? “The motivations are complex,” said Dr. Ben Smith, a radiation oncologist at MD Anderson. “For decades, radiation oncologists were taught to give low daily doses of radiation treatment over a prolonged period of time to limit the long-term side effects of their treatment. This higher daily dose makes a lot of radiation oncologists nervous given prior teaching, and I think this feeling accounts for the reluctance to embrace the newer, shorter approach to breast radiation.”